Early versus late parenteral nutrition for critically ill term and late preterm infants.

Study answer

What this study found

Overall, evidence was insufficient to determine whether early or late parenteral nutrition improves outcomes, but the available trial data favored late PN for several short-term outcomes. In the 209-infant term subgroup, late PN was associated with lower in-hospital all-cause mortality (6/111 vs 15/98; RR 0.35), lower neonatal mortality (4/111 vs 12/98; RR 0.29), and fewer healthcare-associated infections (18/111 vs 30/98; RR 0.53). Late PN also shortened ICU stay by 3.3 days, hospital stay by 9.5 days, and mechanical ventilation by 3.4 days. A possible harm was more hypoglycaemia with late…

Study & population

Systematic review of randomized trials comparing early versus late parenteral nutrition in critically ill term and late preterm infants, defined as gestational age at least 34 weeks to day 28 of life.

Intervention

Early parenteral nutrition was started within 72 hours of NICU/PICU admission, while late parenteral nutrition was started after 72 hours.

Key limitation

The evidence base was very small, with data mainly from a single randomized trial subgroup and only 209 term infants.

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Original abstract